Therapist Interpersonal Skills and Outcomes for Young People

Our primary aim was to assess the associations between outcomes and therapist interpersonal skills (TIS) of empathy, congruence, regard, and unconditionality, as rated by young people. We also aimed to compare these associations against outcome-alliance associations, and to assess whether these associations were specific to a TIS-prioritizing therapeutic practice.

Our primary sample was 167 13-16-year-olds who exhibited emotional symptoms and received up to 10 weeks of school-based humanistic counseling plus pastoral care as usual (SBHC + PCAU). Young people were predominantly female (76%), with 45% Black or other minoritized identity. We measured TIS with the Barrett Lennard Relationship Inventory; and used linear regression modeling to assess TIS associations with outcomes on psychological distress, wellbeing, and satisfaction.

TIS, most markedly congruence, were significantly associated with outcomes, contributing approximately 3% of change. TIS and alliance explained similar proportions of outcomes, with a model including only congruence showing the best fit on psychological distress and wellbeing. We did not find consistent evidence that the TIS-outcome association was specific to humanistic counseling.

Therapists and lay professionals working with young people should strive to develop their interpersonal skills-particularly congruence-within the context of other relationship skills, qualities, and characteristics.